<%@ page contentType="text/html;charset=UTF-8" %>
<%@ include file="/WEB-INF/views/include/taglib.jsp"%>
<div class="content-wrap">
<div class="wrapper" style="bottom: 50px;">
<ul class="nav nav-tabs">
    <li>
        <a href="#" onclick="loadDiv('rigthCenterDiv','${ctx}/nurse/newbornRec/newBornRecList?vistIdOfMother=${newBorn.vistIdOfMother}&patientIdOfMother=${newBorn.patientIdOfMother}')"> 新生儿列表</a>
    </li>
    <li class="active">
        <a href="#" onclick="loadDiv('rigthCenterDiv','${ctx}/nurse/newbornRec/form?vistIdOfMother=${newBorn.vistIdOfMother}&patientIdOfMother=${newBorn.patientIdOfMother}')">
            <c:choose>
                <c:when test="${newbornRec.id==''|| newbornRec.id==null}">
                    新生儿添加
                </c:when>
                <c:otherwise>新生儿修改</c:otherwise>
            </c:choose>
        </a>
    </li>
</ul>

<section class="panel">
    <div class="panel-body">
        <form class="form-horizontal" data-parsley-validate="" id="newBornInfo" role="form" onsubmit="return formSaveLoad('rigthCenterDiv','newBornInfo','${ctx}/nurse/newbornRec/save','${ctx}/nurse/newbornRec/newBornRecList?vistIdOfMother=${newBorn.vistIdOfMother}&patientIdOfMother=${newBorn.patientIdOfMother}');" method="post" class="form-horizontal">
            <input type="hidden" value="${newBorn.id}" name="id">

            <div class="form-group">
                <label class="col-sm-1 control-label" for="name">姓名:</label>
                <div class="col-sm-2">
                    <input type="text" class="form-control" id="name" name="name" value="${newBorn.name}" data-parsley-required="true">
                </div>
                <div class="col-sm-1">
                    <select name="sex" class="form-control" id="sex" data-parsley-required="true">
                        <c:forEach items="${fns:getDictList('SEX_DICT')}" var="sex">
                            <option value="${sex.value}">${sex.label}</option>
                        </c:forEach>
                    </select>
                </div>
                <label class="col-sm-1 control-label" for="birthDay">出生日期:</label>
                <div class="col-sm-2">
                    <input type="text" class="form-control Wdate" id="birthDay" data-parsley-required="true" name="dateOfBirth" value="<fmt:formatDate value="${newBorn.dateOfBirth}" pattern="yyyy-MM-dd"></fmt:formatDate>" onclick="WdatePicker({dateFmt:'yyyy-MM-dd',isShowClear:false,maxDate:'%y-%M-%d'});">
                </div>
                <label class="col-sm-2 control-label" for="motherInpNo">母亲住院号：</label>
                <div class="col-sm-2">
                    <input type="hidden" name="vistIdOfMother" id="vistIdOfMother" value="${newBorn.vistIdOfMother}">
                    <input type="hidden" name="patientIdOfMother" id="patientIdOfMother" value="${newBorn.patientIdOfMother}">
                    <input type="text" class="form-control" id="motherInpNo" readonly name="motherInpNo" value="${newBorn.motherInpNo}" data-parsley-required="true">
                </div>
            </div>
            <div class="form-group">
                <label class="col-sm-1 control-label" for="birhtPlace">出生地:</label>

                <div class="col-sm-1">
                    <input type="text" class="form-control" id="sheng" name="birthPlaceProvince" value="${newBorn.birthPlaceProvince}" placeholder="省">
                </div>
                <div class="col-sm-1">
                    <input type="text" class="form-control" id="shi" name="birthPlaceCity" value="${newBorn.birthPlaceCity}" placeholder="市">
                </div>
                <div class="col-sm-1">
                    <input type="text" class="form-control" id="xian" name="birthPlaceCounty" value="${newBorn.birthPlaceCounty}" placeholder="县">
                </div>
                <div class="col-sm-4">
                    <input type="text" class="form-control" id="birhtPlace" name="birthPlaceTownship" value="${newBorn.birthPlaceTownship}" placeholder="具体出生地">
                </div>
            </div>
            <div class="form-group">
                <label class="col-sm-1 control-label" for="time">怀孕周数:</label>
                <div class="col-sm-1">
                    <input type="text" class="form-control" id="time" data-parsley-type="number" maxlength="2" name="gestationWeek" value="${newBorn.gestationWeek}">
                </div>
                <label class="col-sm-1 control-label" for="health">健康状况:</label>
                <div class="col-sm-1">
                    <input type="text" class="form-control" id="health" name="healthStatus" value="${newBorn.healthStatus}">
                </div>
                <label class="col-sm-1 control-label" for="weight">出生体重:</label>
                <div class="col-sm-2">
                    <div class="input-group mb2">
                        <input type="text" class="form-control" id="weight" name="weight"   data-parsley-type="number" maxlength="4"  value="${newBorn.weight}"><span class="input-group-btn"><button class="btn btn-default" type="button">克</button></span>
                    </div>
                </div>
                <label class="col-sm-1 control-label" for="height">身长:</label>
                <div class="col-sm-2">
                    <div class="input-group mb2">
                        <input type="text" class="form-control" id="height" name="height"  data-parsley-type="number" maxlength="3" value="${newBorn.height}"><span class="input-group-btn"><button class="btn btn-default" type="button">CM</button></span>
                    </div>
                </div>
            </div>
            <div class="form-group">
                <label class="col-sm-1 control-label" for="fenm">分娩方式:</label>
                <div class="col-sm-1">
                    <input type="text" class="form-control" id="fenm" name="birthQuomodo" maxlength="1" value="${newBorn.birthQuomodo}">
                </div>
                <label class="col-sm-1 control-label" for="result">分娩结果:</label>
                <div class="col-sm-1">
                    <input type="text" class="form-control" id="result" name="birthResult" maxlength="1" value="${newBorn.birthResult}">
                </div>
                <label class="col-sm-2 control-label" for="yigan">乙肝疫苗接种:</label>
                <div class="col-sm-1">
                    <select id="yigan" name="drug1" class="form-control">
                          <option value="0" <c:if test="${newBorn.drug1=='0'}">selected="selected" </c:if>>是</option>
                          <option value="1" <c:if test="${newBorn.drug1=='1'}">selected="selected" </c:if>>否</option>
                    </select>
                </div>
                <label class="col-sm-2 control-label" for="kajie">卡界疫苗接种:</label>
                <div class="col-sm-1">
                    <select id="kajie" name="drug2" class="form-control">
                        <option value="0" <c:if test="${newBorn.drug2=='0'}">selected="selected" </c:if>>是</option>
                        <option value="1" <c:if test="${newBorn.drug2=='1'}">selected="selected" </c:if>>否</option>
                    </select>
                </div>
            </div>
            <div class="form-group">
                <label class="col-sm-1 control-label" for="montherName">母亲姓名:</label>
                <div class="col-sm-2">
                    <input type="text" class="form-control" id="montherName" readonly name=nameOfMother value="${newBorn.nameOfMother}">
                </div>
                <label class="col-sm-1 control-label" for="moIDNo">身份证号:</label>
                <div class="col-sm-2">
                    <input type="text" class="form-control" readonly id="moIDNo" name="idNoOfMother" maxlength="18" value="${newBorn.idNoOfMother}" data-parsley-checkidcard="3">
                </div>
                <label class="col-sm-1 control-label" for="motherAge">年龄:</label>
                <div class="col-sm-1">
                    <input type="text" class="form-control" id="motherAge" readonly name="ageOfMother" value="${newBorn.ageOfMother}">
                </div>
                <label class="col-sm-1 control-label">国籍:</label>
                <div class="col-sm-1">
                    <sys:select checkValue="${newBorn.citizenshipOfMother}" name="citizenshipOfMother" lists="${fns:getDictList('NATIONALITY_DICT')}" className="form-control" ></sys:select>

                </div>
                <label class="col-sm-1 control-label" >民族:</label>
                <div class="col-sm-1">
                    <sys:select checkValue="${newBorn.nationOfMother}" name="nationOfMother" lists="${fns:getDictList('NATION_DICT')}" className="form-control" ></sys:select>

                </div>

            </div>
            <div class="form-group">
                <label class="col-sm-1 control-label" for="fatherName">父亲姓名:</label>
                <div class="col-sm-2">
                    <input type="text" class="form-control" id="fatherName" name="nameOfFather" value="${newBorn.nameOfFather}">
                </div>
                <label class="col-sm-1 control-label" for="idNoOfFather">身份证号:</label>
                <div class="col-sm-2">
                    <input type="text" class="form-control" id="idNoOfFather" name="idNoOfFather" value="${newBorn.idNoOfFather}" data-parsley-checkidcard="3">
                </div>
                <label class="col-sm-1 control-label" for="fatherAge">年龄:</label>
                <div class="col-sm-1">
                    <input type="text" class="form-control" id="fatherAge"  data-parsley-type="number" maxlength="3" name="ageOfFather" value="${newBorn.ageOfFather}">
                </div>
                <label class="col-sm-1 control-label" >国籍:</label>
                <div class="col-sm-1">
                    <sys:select checkValue="${newBorn.citizenshipOfFather}" name="citizenshipOfFather" lists="${fns:getDictList('NATIONALITY_DICT')}" className="form-control" ></sys:select>
                </div>
                <label class="col-sm-1 control-label" >民族:</label>
                <div class="col-sm-1">
                    <sys:select checkValue="${newBorn.nationOfFather}" name="nationOfFather" lists="${fns:getDictList('NATION_DICT')}" className="form-control" ></sys:select>
                </div>

            </div>
            <div class="form-group">
                <label class="col-sm-1 control-label" for="address">家庭地址:</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="address" name="homeAddress" value="${newBorn.homeAddress}" placeholder="省/市/县 及具体家庭地址">
                </div>
            </div>
            <div class="form-group">
                <label class="col-sm-1 control-label" >接生机构:</label>
                <div class="col-sm-3">
                    <input type="hidden" name="nameOfFacility" value="${newBorn.nameOfFacility}"/>
                    <input type="text" class="form-control" name="facility" value="${fns:getCompanyName(newBorn.nameOfFacility)}" readonly>
                </div>
                <label class="col-sm-2 control-label" for="birhtPlaceClass">出生地点分类:</label>
                <div class="col-sm-3">
                    <input type="text" class="form-control" id="birhtPlaceClass" name="typeOfPlace" value="${newBorn.typeOfPlace}">
                </div>
            </div>
            <div class="form-group">
                <label class="col-sm-1 control-label" for="birthNo">出生证号:</label>
                <div class="col-sm-2">
                    <input type="text" class="form-control" id="birthNo" name="birthCertifiaationNo" value="${newBorn.birthCertifiaationNo}" data-parsley-required="true">
                </div>
                <label class="col-sm-1 control-label" for="signDate">签发日期:</label>
                <div class="col-sm-2">
                    <input type="text" class="form-control Wdate" data-parsley-required="true" id="signDate" name="dateOfIssue" value="<fmt:formatDate value="${newBorn.dateOfIssue}" pattern="yyyy-MM-dd"></fmt:formatDate>" onclick="WdatePicker({dateFmt:'yyyy-MM-dd',isShowClear:false,maxDate:'%y-%M-%d'});">
                </div>
                <label class="col-sm-2 control-label" for="tanCi">新生儿胎次:</label>
                <div class="col-sm-2">
                    <input type="text" class="form-control" id="tanCi" name="parityNo" value="${newBorn.parityNo}">
                </div>
            </div>
            <div class="form-group">
                <label class="col-sm-1 control-label" for="remarks">备注:</label>
                <div class="col-sm-7">
                    <textarea type="text" class="form-control" id="remarks" name="remarks">${newBorn.remarks}</textarea>
                </div>
            </div>
            <div class="form-group pull-right">
                <input id="btnSubmit" class="btn btn-primary" type="submit" value="保 存">
            </div>
        </form>

    </div>
</section>
</div>
</div>